Hydroxyzine Pamoate Dosing for Pruritus

Dosing Considerations

For adults with pruritus, a dose of 25-50 mg at bedtime is beneficial for sleep due to sedative properties, according to the Annals of Oncology 1, 2
The British Journal of Dermatology recommends that the dose of hydroxyzine should be halved in patients with moderate renal impairment 3, 4
The British Journal of Dermatology also recommends that hydroxyzine should be avoided in severe liver disease due to its sedating effects 3, 4
According to the British Journal of Dermatology, hydroxyzine is specifically contraindicated during early pregnancy according to UK manufacturer's guidelines 3, 4

For mild or localized pruritus, the Annals of Oncology suggests beginning with topical treatments and adding hydroxyzine 25 mg at bedtime if nighttime symptoms are problematic 1, 2
For moderate pruritus, the British Journal of Dermatology recommends considering a non-sedating antihistamine during the day with hydroxyzine at night 3, 4
For severe or widespread pruritus, the Annals of Oncology suggests considering combination therapy with H2 antihistamines and adding GABA agonists for enhanced effect 1, 2